Health Benefit Expense Account (HBEA)

The Health Benefit Expense Account (HBEA) is a program that allows you to set aside money, before taxes, from your paycheck to pay for health-related expenses not covered by insurance. The great advantage is that you pay no federal taxes on your contributions. 

Example

If you put in $1,000 and are in a 20 percent federal tax bracket, you save $200 ($1,000 x 20% = $200).
 
The IRS has modified the "use-it-or-lose-it" provision to now allow HBEA participants to roll over up to $500 in unused funds.
 
If you or your spouse and/or eligible dependents go to the doctor or dentist, take medication or wear glasses, the Health Benefit Expense Account may save you money whether you have insurance or not.
 
Contributions to the HBEA are subject to New Jersey State Income Tax. 

How the Accounts Work 

Setting up the Account

As an enrollee in the HBEA plan, you are provided with a PayFlex Card®. You receive one card and have the option to order additional cards for eligible dependents by contacting PayFlex at (800) 284-4885 or online at HealthHub. The PayFlex Card® may remain valid for up to a five year period. If you re-elect the HBEA from year-to-year, the PayFlex Card® will be loaded with your new election amount each January 1. 
 
When you use the card, it debits your HBEA automatically. The card can be used to pay for eligible products and services at any qualifying provider locations where MasterCard is accepted, including hospitals, physician offices, dental offices, vision service locations and pharmacies. You are not required to use the card. However, the advantage of using the card is that you are accessing your HBEA at the point-of-service, so you do not have to pay out-of-pocket or complete a claim form. After using the card, certain services may require that you provide documentation to PayFlex to substantiate the claim to comply with IRS regulations. If a claim needs to be substantiated, you will receive a notification from PayFlex.
 
PayFlex Card® Changes beginning effective April 1, 2013:
 
  • In the past, when the PayFlex Card® was used, the option of “credit” was always selected at the provider. Beginning effective April 1, 2013, due to the Durbin Amendment a provider may require you to choose “debit” and not let you select “credit.” Therefore, while you may still use your card as “credit”, use of your card as “debit” will require a PIN. To request a PIN for your card please call Card Services at (888) 999-0121. If your spouse or eligible dependent also has a card for your account, they will use the same PIN that you use. For more information on the PIN, please see the FAQ.
  • All new or replacement debit cards received on or after May 1, 2013 will need to be activated before using it. Each card will have an activation label with instructions. To activate your card, you will call (877) 261-9951.

Electing Contributions Annually

Each calendar year, you may choose to contribute between $100 and $2,500 into the account. Elections do not automatically carry over each year. You must make a new election through e-Benefits each year to participate in the Health Benefit Expense Account, even if you are participating in the current year. 

Reimbursement

When you have an eligible expense, you will have the option of:
  • using the PayFlex debit card
  • filing the claim online on the PayFlex website; direct deposit of the reimbursement is availble to your personal checking or savings account
  • scanning, faxing or mailing your receipt with the medical care reimbursement claim form 
You can arrange for direct deposit from your expense account to your personal check or savings account.
 
You have until March 31 of the year following the calendar year to submit claims for eligible expenses you incurred during the previous calendar year. Princeton will allow balances of $50 up to a maximum of $500 of unused funds to be automatically rolled over each year. Any amounts under $50 or over $500 will be forfeited.

Estimating Your HBEA Expenses

Contributions to your HBEA depend on your household needs. 
  • Think about how many copayments you will have for physician visits or prescriptions.
  • Will you pay a deductible?
  • Perhaps you expect a large dental, orthodontic, e.g., braces, or vision expense, e.g., LASIK surgery.
Estimate your expenses carefully because the IRS does not allow you to roll over funds in excess of $500. Any money left in the account under $50 or over $500 will be forfeited.

Expense Account Worksheet

Use the worksheet below to calculate your health care (medical, dental, vision) expenses for the calendar plan year, January 1 - December 31.
 
You can calculate your savings on the website of our third party administrator, PayFlex.
 
Remember:
  • Do not include itemized medical deductions you plan to claim on your annual tax return.
  • Include the health expenses of your spouse and eligible dependents.

Everyday Health Expenses (Not Covered by Insurance)

Dental (non-cosmetic)
___________
Vision (prescription glasses, contact lenses, exams, LASIK, supplies)
 
___________
Prescription drugs
___________
Over-the-counter medication is no longer elibile for reimbursement through HBEA unless you have a prescription from a doctor.  This rule does not apply to items for medical care that are not medicines or drugs.  For example, equipment such as crutches, supplies such as  bandages and diagnostic devices such as blood sugar test kits will still quality for reimbursement in 2013.
 
___________

Expenses Within Your Medical Coverage

Deductible (amount you pay before the plan begins to pay)
 
___________
Co-insurance (percentage you pay after deductible is met)
 
___________
Copayments (for doctor’s office visits)
___________

Other Expenses

Orthodontia (only incurred expenses)
___________
LASIK eye surgery
___________
Chiropractic care
___________
Counseling
___________
Other
___________
Total estimated out-of-pocket expenses
___________

You have until March 31 of the subsequent calendar year to submit claims for health care expenses you have incurred during the previous calendar year. Otherwise, any money left in your account under $50 or over $500 will be forfeited

You can count on support from knowledgeable and responsive HR staff when you have a benefits question or problem. Just call or e-mail us. We’re here to help!

While the University intends to continue each of the benefit plans, the University reserves the right to terminate or amend any plan, at any time, and for any reason.